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Effet de la rééducation perceptivo-motrice sur la récupération de la parole chez deux patientes avec aphasie non fluente chronique post-AVC

Abstract : Recent studies on speech rehabilitation in aphasic patients show that a visual articulatory input can be useful for speech recovery, alongside the auditory input conventionally used. Moreover, the persistence of disorders, despite speech-therapy training generally undergone by these patients, emphasizes the need to develop new methods of speech rehabilitation. In this study, we evaluated a method of rehabilitation based on perceptual motor integration (PMI) – via the Ultraspeech player software – in two patients with chronic non-fluent aphasia after stroke. P1 showed a clinical picture of Broca’s aphasia, while P2 presented a global aphasia after stroke, which later transformed into a Broca’s aphasia. The Ultraspeech player software allows the visualization by the patient of reference tongue movements using ultrasound and video imaging for phonemes. The evaluation of the effect of this method was based on the comparison, before and after reeducation, of multimodal data allowing: a quantitative analysis of the acoustic parameters of the speech signal, a qualitative analysis of language performances and language scores, and a neurophysiological assessment of the anatomo-functional networks recruited in several language tasks. Our results show the efficiency of PMI in P1 but only a limited benefit in P2. In qualitative terms, naming, reading, word repetition, and rhyme detection improved in P1, while P2 declined in reading and rhyme detection. Quantitatively speaking, P1 improved in her production of vowels and consonants whereas P2 only partially improved in the quality of some consonants and vowels. In terms of cerebral correlates, in P1, we observed a modulation of the cerebral activity in language networks, in agreement with the behavioral improvement in speech and language, as well as efficient functional reorganization patterns. We discuss these results in the framework of theoretical models of speech motor control and we describe the conditions of PMI application in patients with non-fluent aphasia.
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Submitted on : Monday, May 20, 2019 - 5:12:45 PM
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Célise Haldin, Audrey Acher, Louise Kauffmann, Thomas Hueber, Emilie Cousin, et al.. Effet de la rééducation perceptivo-motrice sur la récupération de la parole chez deux patientes avec aphasie non fluente chronique post-AVC. Revue de neuropsychologie, neurosciences cognitives et cliniques, Montrouge : John Libbey Eurotext, 2019, 11 (1), pp.44-59. ⟨10.1684/nrp.2019.0485⟩. ⟨hal-02134778⟩

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